Why the nature of Obamacare makes it impossible for it to work

As AT's Rich Baehr said in his email alerting me to this brilliant article by Michael Bernstam of the Hoover Institution, "A perspective well worth the five-minute read. Can simplify a lot of long dinner-party discussions."

Indeed, it can.

Fox News:

The problem with ObamaCare is not that it is poorly designed or sloppily implemented. The problem is in the nature of things: The Patient Protection and Affordable Care Act, as it has been envisaged, is inherently impossible. To see this, forget ObamaCare for the moment. Think health care in general. Health care can be many things for many people:

  • It can be universal (extended to all people) or selective (available to some people).
  • It can be comprehensive (covers all conditions and cures at any age) or rationed.
  • It can be affordable or prohibitively expensive.

But there is one thing that a health care system cannot be. It cannot be everything for everyone.It cannot simultaneously be 1) universal, 2) comprehensive, and 3) affordable.This is the impossible trinity of objectives.

  • If it is universal and comprehensive, it is prohibitively expensive and hence unaffordable.
  • The only way to make it universal and affordable is to ration services, but then the system is not comprehensive.
  • If it is comprehensive and affordable, it can be such only for those who can afford it, and hence not universal.

As in the Omnipotence Paradox, even God can do only what is in the nature of His (and our) universe and cannot do what is ontologically impossible, viz., cannot make 1+1=3. Let alone the 44th president of the United States.

Obamacare is based on political compromise, not rational health care policy. If it was ever going to work, it wouldn't have been "comprehensive" in the sense that it was 2,000 pages of legislative overreach, nor could it logically be "universal" because the only way to achieve that goal would be to coerce Americans into buying it.

Bottom line: there's no fixing Obamacare. It is fundamentally flawed - its very premise a chimera. The more "tweaks" are tried, the worse it gets. What is extremely worrisome is that the entire private insurance market could collapse as Obamacare eventually dies, leaving millions uninsured and vulnerable. 

That would be Obama's legacy - a fitting one indeed.